| NPI | 1669665162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P6888) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-713) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2019-10-22 |